PMID- 33345402
OWN - NLM
STAT- MEDLINE
DCOM- 20220323
LR  - 20220323
IS  - 1600-0625 (Electronic)
IS  - 0906-6705 (Linking)
VI  - 30
IP  - 5
DP  - 2021 May
TI  - New-generation diagnostics in inflammatory skin diseases: Immunofluorescence and 
      histopathological assessment using ex vivo confocal laser scanning microscopy in 
      cutaneous lupus erythematosus.
PG  - 684-690
LID - 10.1111/exd.14265 [doi]
AB  - Ex vivo confocal laser scanning microscopy (CLSM) offers real-time examination of 
      excised tissue in reflectance, fluorescence and digital haematoxylin-eosin 
      (H&E)-like staining modes enabling application of fluorescent-labelled 
      antibodies. We aimed to assess the diagnostic performance of ex vivo CLSM in 
      identifying histopathological features and lupus band test in cutaneous lupus 
      erythematosus (CLE) with comparison to conventional histopathology and direct 
      immunofluorescence (DIF). A total of 72 sections of 18 CLE patients were stained 
      with acridine orange (AO), anti-IgG, anti-IgM and anti-IgA; 21 control samples 
      were stained with AO. Subsequently, ex vivo CLSM examination of all samples was 
      performed in reflectance, fluorescence and digital H&E-like staining modes. 
      Superficial and deep perivascular inflammatory infiltration (94.4%), interface 
      dermatitis (88.9%), spongiosis (83.3%) and vacuolar degeneration (77.7%) were the 
      most common features detected with ex vivo CLSM. Kappa test revealed a level of 
      agreement ranging within "perfect" to "good" between ex vivo CLSM and 
      conventional histopathology. ROC analysis showed that the combination of 
      perivascular infiltration, interface dermatitis and spongiosis detected by ex 
      vivo CLSM has the potential to distinguish between CLE and controls. Basement 
      membrane immunoreactivity with IgG, IgM and IgA was identified in 88.8% (n = 15), 
      55.5% (n = 10) and 55.5% (n = 10) of the CLE samples using ex vivo CLSM, 
      respectively, whereas DIF showed IgG, IgM and IgA positivity in 94.4% (n = 17), 
      100% (n = 18) and 88.9% (n = 16) of patients, respectively. In conclusion, ex 
      vivo CLSM enables simultaneous histopathological and immunofluorescence 
      examination in CLE showing a high agreement with conventional histopathology, 
      albeit with a lower performance than conventional DIF.
CI  - (c) 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Sinem Bagci, Isin
AU  - Sinem Bagci I
AUID- ORCID: 0000-0002-9254-8588
AD  - Department of Dermatology, Stanford University School of Medicine, Stanford, CA, 
      USA.
FAU - Aoki, Rui
AU  - Aoki R
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
FAU - Vladimirova, Gabriela
AU  - Vladimirova G
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
FAU - Ergun, Ecem
AU  - Ergun E
AD  - Department of Dermatology and Venereology, Istanbul Training and Research 
      Hospital, Istanbul, Turkey.
FAU - Ruzicka, Thomas
AU  - Ruzicka T
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
FAU - Sardy, Miklos
AU  - Sardy M
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
AD  - Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, 
      Semmelweis University, Budapest, Hungary.
FAU - French, Lars E
AU  - French LE
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
FAU - Hartmann, Daniela
AU  - Hartmann D
AD  - Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210121
PL  - Denmark
TA  - Exp Dermatol
JT  - Experimental dermatology
JID - 9301549
SB  - IM
MH  - Basement Membrane/*pathology
MH  - Biopsy
MH  - *Fluorescent Antibody Technique, Direct
MH  - Humans
MH  - Lupus Erythematosus, Cutaneous/*pathology
MH  - *Microscopy, Confocal
MH  - Staining and Labeling
OTO - NOTNLM
OT  - diagnostics
OT  - direct immunofluorescence microscopy
OT  - ex vivo confocal laser scanning microscopy
OT  - fluorescence
OT  - lupus erythematosus
EDAT- 2020/12/22 06:00
MHDA- 2022/03/24 06:00
CRDT- 2020/12/21 06:13
PHST- 2020/12/08 00:00 [revised]
PHST- 2020/09/24 00:00 [received]
PHST- 2020/12/14 00:00 [accepted]
PHST- 2020/12/22 06:00 [pubmed]
PHST- 2022/03/24 06:00 [medline]
PHST- 2020/12/21 06:13 [entrez]
AID - 10.1111/exd.14265 [doi]
PST - ppublish
SO  - Exp Dermatol. 2021 May;30(5):684-690. doi: 10.1111/exd.14265. Epub 2021 Jan 21.